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Out of Date: Covid-19 Alberta Health Daily Checklist (For Adults 18 Years and Older)
Out of Date: Covid-19 Alberta Health Daily Checklist (For Adults 18 Years and Older)
Overview
This tool was developed to support schools, activity organizers, employers, businesses and facility
operators in reducing the risk of transmission of COVID-19 among attendees/staff. The tool is meant
to assist with assessing attendees who may be symptomatic, or who may have been exposed to
someone who has COVID-19.
Attendees should complete this checklist prior to participating in the activity or program.
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If an individual answers YES to any of the questions, they must not be allowed to attend or
participate in the activity or program. *Individuals with fever, cough, shortness of breath, runny nose, or
sore throat, are required to isolate for 10 days per CMOH Order 05-2020 OR receive a negative
COVID-19 test and feel better before returning to activities.
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Use the AHS Online Assessment Tool to determine if testing is recommended and follow information
on isolation requirements.
As the COVID-19 pandemic continues to evolve, this screening tool will be updated as required.
Screening Questions
1. Does the attendee have any new onset (or worsening) of any of the CIRCLE ONE
following symptoms:
Fever* YES NO
Cough* YES NO
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Shortness of breath / difficulty breathing* YES NO
Runny nose* YES NO
Sore throat* YES NO
Chills YES NO
Painful swallowing YES NO
Nasal congestion YES NO
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Headache YES NO
Conjunctivitis (commonly known as pink eye) YES NO
2. Has the attendee travelled outside of Canada in the last 14 days? YES NO
(Individuals are legally required to quarantine for 14 days when entering
or returning to Alberta from outside Canada unless exempted by the
Alberta COVID-19 Border Testing Pilot Program.)
Has the attendee had close contact1 with a case2 of COVID-19 in the
3. YES NO
last 14 days?
1
Face-to-face contact within 2 metres. A health care worker in an occupational setting wearing recommended personal protective equipment is
not considered to be a close contact.
2A lab-confirmed case OR a probable case as defined in the Alberta COVID-19 Notifiable Disease Guideline.
Classification: Public
COVID-19 INFORMATION
Overview
This checklist applies for all children, as well as all students who attend kindergarten through Grade 12,
including high school students over 18. Children should be screened every day by completing this checklist
before going to school, child care or other activities. Children may need a parent or guardian to assist them
to complete this screening tool.
Screening Questions
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1. Has the child:
(Choose any/all possible exposures)
Traveled outside Canada in the last 14 days? YES NO
When entering or returning to Alberta from outside Canada, individuals are legally
required to quarantine for 14 days (see note below)
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Had close contact with a case1 of COVID-19 in the last 14 days? YES NO
Face-to-face contact within 2 metres for 15 minutes or longer, or direct physical
contact such as hugging
If the child answered “YES” to any of the above:
The child is required to quarantine for 14 days from the last day of exposure.
Note: If the child is participating in the Alberta COVID-19 International Border Pilot Project,
they must comply with the program restrictions at all times.
If the child develops any symptoms, use the AHS Online Assessment Tool or call Health Link
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811 to determine if testing is recommended.
If the child/youth answered “NO” to both of the above:
Proceed to question 2.
2. Does the child have any new onset (or worsening) of the following core symptoms:
Fever YES NO
Temperature of 38 degrees Celsius or higher
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Cough YES NO
Continuous, more than usual, not related to other known causes or conditions such as
asthma
Shortness of breath YES NO
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Continuous, out of breath, unable to breathe deeply, not related to other known causes
or conditions such as asthma
Loss of sense of smell or taste YES NO
Not related to other known causes or conditions like allergies or neurological disorders
If the child answered “YES” to any symptom in question 2:
The child is to isolate for 10 days from onset of symptoms.
Use the AHS Online Assessment Tool or call Health Link 811 to arrange for testing and to
receive additional information on isolation.
If the child answered “NO” to all of the symptoms in question 2:
Proceed to question 3.
1
A lab-confirmed case OR a probable case as defined in the Alberta COVID-19 Notifiable Disease Guideline.
Classification: Public
3. Does the child have any new onset (or worsening) of the following other symptoms:
Chills YES NO
Without fever, not related to being outside in cold weather
View the current version of this checklist at https://open.alberta.ca/publications/covid-19-information-alberta-health-daily-checklist
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Not related to other known causes or conditions, such as anxiety or medication
Muscle/joint aches YES NO
Not related to other known causes or conditions, such as arthritis or injury
Headache YES NO
Not related to other known causes or conditions, such as tension-type headaches or
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chronic migraines
Conjunctivitis (commonly known as pink eye) YES NO
If the child answered “YES” to ONE symptom in question 3:
Keep your child home and monitor for 24 hours.
If their symptom is improving after 24 hours, they can return to school and activities
when they feel well enough to go. Testing is not necessary.
If the symptom does not improve or worsens after 24 hours (or if additional symptoms
emerge), use the AHS Online Assessment Tool or call Health Link 811 to check if testing
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is recommended.
Please note: If your child is experiencing any symptoms from the lists above, do not bring them to visit a
continuing care or acute care facility for 10 days from when symptoms started/until symptoms resolve
(whichever is longer), unless they receive a negative COVID-19 test result and feel better.
Classification: Public